John Snow (1813 – 1857) and Seebohm Rowntree (1871 -1954), both born in York, both also played crucial roles in the development of public health care and the evolution of the welfare state.
Snow is widely regarded as a key figure in the development of epidemiology and of preventative public health measures (clean water supplies, effective sewerage and drainage). Rowntree’s famous investigation of poverty in York (the Study of Poverty 1901) identified low wages, sickness, unemployment and old age as key factors behind deprivation, not the fecklessness and improvidence that were seen as being at the root of poverty according to the Victorian values prevalent at the time. Rowntree’s work led to an increase in the wages of Rowntree chocolate factory workers at the time. More importantly, it influenced politicians and policy makers and can be seen as a fore-runner of the Beveridge Report (1942) and the establishment of the post war Welfare State and the NHS.
It is important to bring to mind the work of these reformers and the effects it has had at a time when the welfare state and the NHS are facing severe threats and cutbacks.
For example, life expectancy has been increased by 30-40 years since ‘the bad old days’ (people could generally expect to live only to their 50s in 1901) (figure 1) infant mortality has fallen from 150/1000 births in 1901 to 4.7/1000 births in 2008 (figure 2).
What is even less appreciated is the impact on standard of living of the existence of our welfare state. It increases the ability of people to spend money and so keep the economic wheels turning. When health care, for example, is paid for collectively through taxation, people have higher disposable incomes (money to spend), making their lives more comfortable and enjoyable, and providing employment and economic buoyancy generally. Any government that overlooks this fundamental outcome of the existence of the NHS and welfare provision risks killing the ‘goose that lays the golden egg’. We can’t afford NOT to have a welfare state and public health care. They bring huge benefits economically. Above all, they bring peace of mind – something denied (for example) to US citizens who live in fear of serious illness and its financial consequences, even for those who manage to afford private insurance.
York can take pride in the influence of Snow and Rowntree on the development of our benevolent system: the least we can do today is ensure their pioneering work is not destroyed. We must all fight to defend the NHS and the safety net of the welfare state.